Chapter 27: Disorders of Cardiac Function, and Heart Failure and Circulatory Shock - MLQ

The third week of development

A neonate is born with a congenital heart defect. The nurse realizes this defect most likely originated during which week of development?

Raising the head of the bed to a high Fowler's position

A nurse preceptor is evaluating the skills of a new registered nurse (RN) caring for clients experiencing shock. Which action by the new RN indicates a need for more education?

Laryngeal edema

Anaphylactic shock is the most severe form of systemic allergic reaction. Immunologically medicated substances are released into the blood, causing vasodilation and an increase in capillary permeability. What physiologic response often follows the vascular response in anaphylaxis?

fills rapidly; compresses

Cardiac tamponade and pericardial effusion can be life-threatening when the pericardial sac _______ and ______ the heart.

-Aortic stenosis can cause left-sided failure. -Cardiomyopathy is a common cause of heart failure. -Compensated heart failure may be clinically asymptomatic.

Regarding the various forms of heart failure, the nurse knows that which statements are correct? Select all that apply.

Release nitric oxide

Sepsis is growing in incidence in the United States. Its pathogenesis includes neutrophil activation, which kills microorganisms. Neutrophils also injure the endothelium, releasing mediators that increase vascular permeability. What else do neutrophils do in sepsis?

Lymph nodes

The nurse is caring for a client with mediastinal carcinoma. Which body structures located in this area are responsible for filtering foreign particles from the interstitial spaces of the lungs to prevent the spread of this cancer?

20 mL/hour

The nurse is monitoring hourly urine output of a client diagnosed with hypovolemic shock. The nurse is most concerned if the client's output is:

Septic shock

The nurse should anticipate administering intravenous antibiotic therapy as a priority to a client experiencing which type of shock?

Structural heart defects

What is the primary cause of heart failure in infants and children?

Congenital heart defects occur between the 3rd and 8th weeks of development before you know you are pregnant.

What should the nurse teach the pregnant woman about congenital heart defects?

Teenager with untreated strep throat

Which client is at the greatest risk of developing rheumatic heart disease?

Low cardiac output due to reduced pumping ability

Which description sums up the basic pathophysiology of heart failure that the nurse would include when educating a client?

In compensated heart failure, an increase of end-diastolic volume causes increased force of left ventricular contraction.

Which statement regarding heart failure is true?

Stretch

Which type of lung receptor monitors for lung inflation?

recording weight every day at the same time with same type of clothing.

While teaching a client with new-onset right-sided heart failure, the nurse should educate the client to monitor for fluid accumulation by:

Hypertrophic cardiomyopathy

A 17-year-old athlete died suddenly during a track meet and it was subsequently determined that he had heart disease. Which condition was the most likely cause of his heart failure?

Low blood pressure

A 30-year-old client arrives with these vital signs: Blood pressure 50/30 mm Hg, pulse 100 beats/min, respiratory rate 12 breaths/min, temperature 101°F (38.3°C). The nurse interprets these results as the client being in shock based on which reading?

When the client experiences chest pain

A 45-year-old client is undergoing exercise stress testing. At which point will the test be halted and not allowed to continue?

Pericardial effusion

A client comes to the emergency room exhibiting signs and symptoms of right-sided heart failure. Upon X-ray it is determined that he has 250 mL of fluid in the pericardial cavity. Which disease should the nurse suspect this client is suffering?

Troponin assays

A client comes to the emergency room with all the symptoms of a myodardial infarction. Which lab value, known to have a high specificity for myocardial tissue considered the primary biomarker test for diagnosing an MI, does the nurse suspect the physician will order?

Prompt diagnosis and treatment of streptococcal infections

A client is at high risk for the development of rheumatic heart disease. The most important information for the nurse to provide would be

Administer epinephrine (adrenaline).

A client is transported to the emergency department in respiratory distress after eating peanuts. The following interventions are ordered by the health care provider. Which intervention should the nurse complete first?

vasodilating effects reducing preload and afterload

A client who lives with angina pectoris has taken a sublingual dose of nitroglycerin to treat the chest pain he experiences while mowing his lawn. This drug facilitates release of nitric oxide, which will have what physiologic effect?

Onset of STEMI

A client with a long history of stable angina suddenly experiences substernal pain that radiates to the left arm, neck, and jaw. He describes the pain as severe and feels as if he is suffocating. He has taken nitroglycerin and not experienced any relief. The client is most likely experiencing:

"Since your heart is not pumping efficiently, the kidneys are getting less blood flow; therefore, the kidneys are holding on to sodium and water."

A client with heart failure asks, "Why am I taking a 'water pill' when it's my heart that is having a problem?" While educating the client about the Frank-Starling mechanism, which explanation is most appropriate to share?

The affinity of hemoglobin for oxygen is decreased.

A client's oxygen-hemoglobin dissociation curve is represented by a shift to the right. The nurse recognizes this as which principle?

"For unknown reasons, you lose intrapleural negative pressure. This means your lungs collapsed and expelled its air when you lose negative pressure."

A college student is training for a marathon in the mountains. One day, she experiences a sharp pain and suddenly becomes short of breath. At the emergency room, chest x-ray reveals a spontaneous pneumothorax. The client asks the nurse to explain why this happened. The nurse states:

Multiple sclerosis

Dyspnea is defined as an uncomfortable sensation or difficulty in breathing that is subjectively defined by the client. Which disease state is not characterized by dyspnea?

Compensatory mechanisms

For clients with heart failure, which pathophysiologic response helps maintain the cardiac reserve?

They have the same compensatory mechanisms.

Heart failure and circulatory shock are both conditions of circulatory system failure. Which statement regarding these conditions is correct?

improving quality of life by relieving symptoms.

The health care team is developing a plan of care for a client diagnosed with congestive heart failure (CHF). The primary treatment goal would be:

Morphine

The nurse working in the emergency room triages a client who comes in reporting chest pain, shortness of breath, sweating and elevated anxiety. The physician suspects a myodardial infarction. The client is given a nitrate, which does nothing for his pain. Which medication should the nurse suspect the doctor will order next for the pain?

Constrictive pericarditis

The nursing instructor is teaching her nursing students about cardiac function and different heart diseases. Which disease does she tell the students is caused by calcified scar tissue that develops between the visceral and parietal layers of the serous pericardium?